What is PCOS?
Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder in women and the leading cause of infertility in women. PCOS is a metabolic disorder where the hormones testosterone, oestrogen and progesterone are out of balance. This imbalance leads to the growth of ovarian cysts (benign masses on the ovaries). Women suffering from PCOS may experience symptoms such as irregular periods, acne, oily skin, excessive hair growth and weight gain. PCOS has been linked to numerous issues such as infertility, cardiac function, insulin resistance, diabetes, depression, migraines and metabolic disorders. Insulin resistance is a major characteristic of PCOS and is now commonly being referred to as type 3 diabetes. Insulin is secreted by the pancreas to regulate levels of glucose in our blood. As women with PCOS are resistant to the action of insulin in their body they produce higher levels of insulin to overcome this. This contributes to the increased production and activity of hormones such as the predominantly male hormone testosterone. If you are overweight or obese this also increases the amount of insulin your body produces.
How does PCOS affect fat loss?
PCOS is commonly associated with obesity, however weather PCOS is a result or consequence of obesity is subject to the individual. Although, obesity is not obligatory with many ‘lean’ women also suffering from the condition. Women suffering from PCOS generally report fat gain and difficulty losing body fat. Often in PCOS, the fat gain is localised to the upper body sites and abdominal area.
A study investigating hormone levels in women with PCOS in comparison to women with non-PCOS related infertility found fasting insulin and insulin resistance were elevated in women suffering from PCOS (1). They also reported PCOS women had a higher waist: hip ratio and higher BMI. Being insulin resistant means that your cells fail to respond normally to the hormone insulin. Your body secretes insulin when glucose is elevated in the blood stream in response to carbohydrate intake (1). In the case of insulin resistance the excess glucose is taken to the fat cells for storage.
Another study found women with PCOS also have elevated leptin levels compared to non PCOS controls (2). Leptin is a messenger hormone between the brain and our fat cells that controls our appetite. When leptin is impaired it increases our appetite so we can eat more. Higher leptin levels may be correlated with insulin resistance, metabolic disorders, infertility and even cardiovascular disease (3). It may also contribute to fat gain by increasing appetite and thereby calorie intake.
How to lose fat when you have PCOS
The goals of treatment for women with PCOS are weight loss, improved hormonal function and prevention of metabolic disorders. Thereby, a structured, progressive and tailored nutrition and strength training program is paramount to losing body fat and improving quality of life with PCOS. Then nutritional focus needs to be on consuming a diet low in saturated fat, high in fibre and primarily low GI carbohydrates (4). Due to the insulin resistance associated with PCOS following a nutrition plan that focuses on insulin management is very important. The effects of a high protein, high fat (healthy fats) and lower carbohydrate diet on improving insulin sensitivity and reducing body fat are profound in the scientific literature.
Strength training is an excellent way to shape the body and drop excess body fat. Strength training releases a large amount of growth hormone into your system and as such can greatly affect insulin resistance. Growth hormone is one of the primary elements needed for successful energy utilisation and metabolic function within the body; it impacts insulin resistance levels by assisting insulin in the modulation of carbohydrate control. A recent study on resistance training discovered that moderate-intensity; high-volume resistance training improves insulin sensitivity (5). Making progressive and regular strength training extremely beneficial to woman who suffer from PCOS. Further, strength training increases the size of the skeletal muscle and which enhances the muscles’ ability to manage glucose, resulting in improved insulin sensitivity. So, even if regular visits to the weight room don’t move the numbers on the scale a great deal, as a woman with PCOS, you can still improve your overall health, hormonal function and prevent metabolic disorders commonly associated with PCOS (6). Ideally, you would tailor your carbohydrate intake around your workouts as this is where you are most insulin sensitive.
Beneficial supplements to take when you have PCOS
There are a certain number of beneficial supplements you can take to help combat the side effects of having PCOS, especially if taken alongside regular strength training and a healthy diet.
Alpha Lipoic Acid: ALA is a potent antioxidant and is known for its insulin mimicking properties as it effectively mimics the action of insulin in your body. ALA is responsible for activating multiple pathways involved in transport of glucose into muscle cells but also cell signaling that leads to muscle growth, improved insulin sensitivity of the cells and increased glycogen storage capacity. Pretty impressive isn’t it? These mimicking properties also make it extremely effective in combatting PCOS symptoms. A study found females with PCOS who supplemented with ALA for 16 weeks were able to improve their insulin sensitivity by 13.5% (7).
Chromium: Chromium is a micro-mineral that has some incredible benefits when it comes to controlling insulin. Chromium can assist in carbohydrate metabolism within your body, enhance insulin receptor activity and even increase the pancreases sensitivity to glucose levels in the blood. Further, chromium can also increase the number of insulin receptors and support insulin signaling reducing the risk of insulin resistance making it a must have supplement for those with PCOS. A study revealed a 38% improvement in glucose disposal rate following chromium supplementation in women with PCOS (8).
Fish oil: Fish oil provides you with an excellent source of omega-3 fatty acids like Docosahexaenoic acid (DHA) and Eicosapentaenoic acid (EPA). If you suffer from PCOS fish oil is an effective supplement for modulating testosterone, aiding to to reduce fatty liver, cholesterol, and triglycerides, reduce inflammation and it and lower blood pressure.
Vitamin D: Low vitamin D levels are present in more than 50% of patients with PCOS (9). Vitamin D plays an important role in immune health, bone health and cognition as well as preventing a range of diseases. A study showed supplementation with Vitamin D in PCOS patients resulted in weight loss, improvements in menstrual regularities and improvement of hyperandrogenism (excess androgen levels such as testosterone) (10).
PCOS can prove as a challenge and in certain ways can make things a little harder especially in regards to weight and fat loss. They key is to understand how it affects your body and what it is you can do to combat these effects. With a structured training regime and diet plan you should be able to effectively improve your health along with your waistline. If you suffer from PCOS and have any questions about losing body fat feel free to email me at [email protected]
- Tsai, Y. H., Wang, T. W., Wei, H. J., Hsu, C. Y., Ho, H. J., Chen, W. H., … & Chao, J. C. J. (2013). Dietary intake, glucose metabolism and sex hormones in women with polycystic ovary syndrome (PCOS) compared with women with non-PCOS-related infertility.British journal of nutrition, 109(12), 2190-2198.
- Reaven, G. M. (1988). Role of insulin resistance in human disease.Diabetes, 37(12), 1595-1607.
- Zheng, S. H., Du, D. F., & Li, X. L. (2016). Leptin Levels in Women With Polycystic Ovary Syndrome A Systematic Review and a Meta-Analysis.Reproductive Sciences, 1933719116670265
- Marsh, K., & Brand-Miller, J. (2005). The optimal diet for women with polycystic ovary syndrome?.British Journal of Nutrition, 94(02), 154-165.
- Resistance Training Improves Insulin Sensitivity in NIDDM Subjects Without Altering Maximal Oxygen Uptake Tomofusa Ishii, Tetsuya Yamakita, Toshihiko Sato, Shiro Tanaka, Satoru Fujii Diabetes Care Aug 1998, 21 (8) 1353-1355; DOI:2337/diacare.21.8.1353
- Resistance Training and Type 2 Diabetes – Neil D. Eves, Ronald C. Plotnikoff Diabetes Care Aug 2006, 29 (8) 1933-1941; DOI:2337/dc05-1981
- Kayali, R., Cakatay, U., Akçay, T., & Altuğ, T. (2006). Effect of alpha‐lipoic acid supplementation on markers of protein oxidation in post‐mitotic tissues of ageing rat.Cell biochemistry and function, 24(1), 79-85.
- Lucidi, R. S., Thyer, A. C., Easton, C. A., Holden, A. E., Schenken, R. S., & Brzyski, R. G. (2005). Effect of chromium supplementation on insulin resistance and ovarian and menstrual cyclicity in women with polycystic ovary syndrome.Fertility and sterility, 84(6), 1755-1757.
- Glintborg, D., & Andersen, M. (2016). MANAGEMENT OF ENDOCRINE DISEASE: Morbidity in polycystic ovary syndrome.European Journal of Endocrinology, EJE-16.
- Dehghani Firouzabadi, R., Aflatoonian, A., Modarresi, S., Sekhavat, L., & MohammadTaheri, S. (2012). Therapeutic effects of calcium & vitamin D supplementation in women with PCOS.Complementary therapies in clinical practice, 18(2), 85-88.